Classic homebirth screw-ups lead to yet another homebirth death

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Another day, another baby who didn’t have to die at homebirth.

According to The Irish Times:

A couple who prepared for what they hoped would be an idyllic home birth by lighting candles and playing soothing sounds on their stereo ended up devastated when their baby was stillborn, an inquest heard today.

Too bad they thought candles and music constituted a perfect birth. Personally, I think a live, healthy baby makes a perfect birth and candles and music be damned.

What happened? The story follows the usual homebirth disaster script:

1. A long labor:

On May 23th, 2011, she awoke with abdominal cramps. Ms Engel arrived at about 11.30am. She again arrived at about 6pm and at about 10.30pm told her she could see “the top of the child’s head, his black hair”.

At around 12pm she said to the midwife that she felt it was taking too long, and just after 1am she said it again that she couldn’t get the baby out.

2. Lack of appropriate fetal monitoring and resulting in the “sudden” loss of the baby’s heartbeat:

The midwife told her to push harder but at about 1.30am the baby’s heartbeat had changed and she could not get a reading.

3. The father who insists that they should take the mother to the hospital.

… [H]er partner, suggested it was time she go to the hospital and the midwife agreed…

He said that at approximately 12.30am or 1am he turned off the music. The mood intensified. He saw and heard the baby’s heartbeat diminish and he had enough of what he was seeing and said straight out: “let’s go to the hospital”.

4.The failure to call an ambulance.

5. Delay in getting to the hospital:

However, the midwife’s car would not start and they had to transfer oxygen into her partner’s car. The three of them drove to the hospital in Mr Henaghan’s car.

By the time they got to the delivery suite it was 3am. Staff did an ultrasound on the baby and could not get a reading. The baby was stillborn at 3.23am.

6. The frantic attempts of hospital staff to resuscitate the baby, attempts that ultimately failed.

7. The midwife’s regrets:

[The mother] said that in the hospital immediately after it was clear that Kai had died, Ms Engel [the midwife] said she would never do a home birth again as long as she lived and kept saying “I am so sorry, I am so sorry.”

8. Failure to appropriately monitor the baby’s heart rate:

There was an “unfortunate absence” of foetal heart monitoring records in the medical notes.

9. The midwife changing her story and denying culpability:

In evidence today Ms Engel denied stating in the hospital after the stillbirth she would never do another home birth and also denied being reluctant to transfer her patient to hospital.

She also said she had carried out regular heartbeat checks during the attempted delivery and denied her car was unreliable, stating the problem starting it had been “transient”.

10. The classic exchange of the “birth experience” for the life of the baby:

[The father] said his girlfriend wanted to go down the route of having as natural a birth and pregnancy as possible and contacted Ms Engel, the only local midwife in Mayo. She only wanted to go to hospital if it meant the baby’s birth was at risk.

[He] said: “As part of Sarah’s natural birthing plans she had organised some music or sounds on the stereo to be played, some candles to be lit.

“Every aspect of the house was set out in the way she wanted it for the day of the birth.”

Too bad she didn’t worry more about the health of the baby, and less about an idyllic homebirth.

  • Dr Kitty

    http://aimsireland.com/files/AIMSI_HealthyBirthDirectory_West.pdf

    Checking this 2011-2012 piece of NCB propaganda ( example:”What are the disadvantages of attempting a VBAC? There is potential for the scar on the uterus to weaken and separate. This occurs in approx 1 in 200 births. If there are signs of this complication an emergency Caesarean Section will be advised.” No mention that rupture could kill you or the baby) Ms Engel works in County Sligo, County Galway and County Mayo. It is about 2-3 hours from Galway city to Sligo. Rather a large catchment area.

    As opposed, for example, to another MW in the same pamphlet who is very clear that she works within 10 miles of Galway city centre, and another MW who offers care within 50 miles of Athlone.

    • DaisyGrrl

      “The scar on the uterus may weaken and separate” – sounds like a variation of normal to me. No problem for a midwife. “Your uterus might rupture and endanger your baby’s life, your life, and/or end your ability to have children” is a medical complication that is easily foreseeable. Having such an obvious obstetric risk factor means giving birth in a nasty hospital with machines and interventions and eebil nurses and OBs who will cut you open so they can get home to dinner.

      VBAC is really not something anyone has any business attempting outside of a hospital, but with the language the midwives use it’s easy to see why people could be fooled. A scar weakening and separating sounds gentle and not like the very big deal that it actually is.

  • R T

    This makes me so damn sad! When I worked as a doula I came complete with a bag full of flameless candles, a CD player, “birth” music CDs, aromatherapy, massagers and all other sorts of mood enhancing items. They were always welcomed enthusiastically by the hospital staff. We would dim the lights, turn on the candles, put on whatever music mom wanted. I can’t imagine it would all be banned in Ireland? Does anyone know? Of course, had this happened in the hospital, they would have a living baby, but mom would be mourning the loss of her natural birth and blaming the complications on the interventions and the unnatural flameless candles.

    • Dr Kitty

      Not banned in Ireland AFAIK.
      Perhaps a the room is more institutional, but there would rarely be a problem with aromatherapy, music, massage etc.

    • Fidelma

      Not banned in Ireland. I had the music I wanted at my recent labour. Am sure other things would have been welcome too.

  • Leica

    You know, a lot of hospitals and OBs are pretty accommodating with details too, as long as it’s not a danger. Mine was on board with everything I wanted for my repeat c-section, and even suggested that I could make a CD to bring and play in the OR. I got to hold my baby on my chest, covered in a warm blanket, while being stitched up. I even got a mirror to watch him be born. That took a fair bit of discussion, but he still agreed. I wouldn’t recommend the mirror for most people, but I loved being able to see the whole thing.

    Granted, my first baby was born at a Naval hospital where you were expected to have your baby in the manner that maximized bed turnover and inconvenienced the staff the least. Even there though, you could have music and (fake) candles while laboring.

  • Zornorph

    My surrogate was watching Fraiser re-runs on the TV in the delivery room. I nearly named my son Niles.

    • Elizabeth A

      Hey! Did that just happen? Congratulations!

      • Zornorph

        Thanks. He was born the first week in August. 🙂

  • Pam

    What is so horrible about wanting the idyllic experience? It really is the most important part of having a baby.This couple should not be punished for their choices.

    • Sullivan ThePoop

      That is the least important part to me. I just want everyone to be safe and sound with all of their brain cells intact. My birth experiences were neither good nor bad, they just were. Now my babies on the other hand. Well, I could go on all day.

    • BeatlesFan

      I’m going to give you the benefit of the doubt and assume you were being snarky.

    • Amy Tuteur, MD

      “… As childbearing became safer and more benign visions of nature arose, undesired outcomes of birth for women came to consist of a bad experience and psychological damage from missed bonding opportunities. Today, with safety taken for granted, the new goal has become in some sense the process itself: the experience of childbirth…”

      But safety shouldn’t be taken for granted. Childbirth seems safe BECAUSE of obstetricians and hospitals, and isn’t safe without them.

      http://www.skepticalob.com/2011/12/melissa-cheyney-is-not-only.html

    • theadequatemother

      I always felt the baby was the most important part of “having a baby.” Silly me…so pedestrian in my thinking.

      • Bombshellrisa

        The baby is just sort of an add on bonus if it lives, cause the experience of birth is so much more important than actually getting to do the parenting part (like dressing your baby in silly onesies, laughing about her having your great aunt’s curly hair and taking embarrassing pics to share later). /snark

      • The difficulty is when “the baby” becomes all that matters – it is the thing that matters the most, the thing that justifies sacrificing other things – like being in the comfort of your own home, but good quality care has to be more than just the baby, and it should be more than coming out of it alive (that should be the bare minimum). We have to consider the potential for long run disability and psychological harm and what can be done to minimize that potential. That does not mean that safety should be sacrificed – rather it means recognizing the patient as a partner in their own care. Great OB’s and care providers understand this and do a great job of it.

      • MichelleJo

        For many people having a baby is about the pregnancy and birth experience, choosing a stroller, setting up a nursery, showing off the baby. They seem to forget that the baby doesn’t disappear after that. Babies are a life sentence. I was in a store one day last week and I heard a raised woman’s voice swearing with ‘words’ I’d never heard of and some that I wish I hadn’t, and then realized that it was all being directed towards her around four year old daughter. I bet she had skin to skin contact with her when she was born though.

    • Anj Fabian

      The most important part of having a baby is….
      .
      “having an idyllic experience”?
      Most people think giving birth to a dead baby destroys any chance of having an idyllic experience.

      But…you may be one of the exceptions.

    • Something From Nothing

      What a horrible thing to say…

    • Lizz

      What if instead of staying home for candles and music they just got some battery powered tea lights and a cd player? Nothing is wrong with idyllic except when it get’s in the way of safety.

      • Bombshellrisa

        Lots of hospitals have stereos that play cds and have hook up for Ipods. Some have in demand movies and tv shows and music stations through the tv. Nothing wrong with candles in some places either, you just have to check the policy. There is a hospital here that offers massage in room and they light lavender scented candles and have music playing.

        • Lizz

          Mine had all the tv and music you could want but had a strict “no fire” policy. But they will accommodate any just about any religious, cultural or person wish as long as it doesn’t violate policy. They forbid waterbirth but will let you labor in water, make you stay on the fetal monitoring only for 20 minutes every two hours unless something is wrong, and you don’t have to lay down but they won’t let you stand up for the birth for safety reasons.
          All this available in Payson,Utah population 18,000 and literally the edge of civilization. These big cities cities must have much more options.

          • Bombshellrisa

            I think most women who assume they can’t have music or whatever haven’t toured a lot of hospital L&D units!

          • Young CC Prof

            My hospital also has comfy birthing suites, choice of pain relief or natural, choice of positions up until the actual birth, and bathtubs. (They also have an operating theatre and a level 2 NICU just an elevator ride away, isn’t THAT relaxing and comforting?)

            I think a lot of these women are acting out of fear of the kind of “hospital birth experience” that hasn’t been common in over a generation.

          • Lizz

            Yeah it’s like when you run into birth plans that say they don’t want a shave or enema. Even with fetal monitoring sometimes they have a telemetry unit so cFM doesn’t tie you to the bed.
            When I read Ina May’s guide to childbirth it all talked about hospital birth in the 70’s,80’s some of the stories of previous birth were from the the 60’s I think. No wonder their ideas of what happens in hospitals is out of date, all of the natural childbirth books are.

          • Tim

            It’s like how there is still a perception that the hospital will do everything they can to prevent you from breastfeeding, when in reality, 97 different total strangers will come and mash your newborns face into your breasts every opportunity they get nowadays.

          • Lizz

            Yep. People act like the nursing staff is just trying to sabotage their breastfeeding and that they have to keep the baby with them all the time or the nursing staff will give them formula. When I was nursing my first in the hospital it took me being literally falling asleep talking to them for them to give him a bottle.

          • Young CC Prof

            I think half the problem with the natural childbirth movement is this: They originally wanted some pretty reasonable stuff, like NOT being drugged unconscious, shaved, and/or forced to lie flat on their backs through the whole labor, like being able to see and hold the baby right away, not days later, like having the OPTION to breastfeed supported.

            They got all of those reasonable things. Almost all hospitals do them unless there are really good medical reasons not to in your particular case. Then the movement got a little confused.

          • Amy Tuteur, MD

            I suspect it is cognitive dissonance. They could either acknowledge that breastfeeding is hard and often painful, or they could pretend that more women would breastfeed if only they were “supported.”

          • Elizabeth A

            I’m sure more women *would* breastfeed if properly supported, by adequate PAID maternity leave time. I really think that the hospital lactation support is kind of behind the point – if you have to get back to waiting tables three weeks after the birth, and your asshole manager fired the last girl who asked for a pumping break, what would you feed your baby?

          • not in my experience. they were pushing formula on me hard.

          • Tim

            The first nurse who told us we “had” to give formula right then and there (her blood sugar was 22mg/dl – eg; close to seizure level) , was very apologetic about it. All three hospitals we did time in the first month, went out of their way to find a schedule that would work for my daughters needs, and my wife’s desire to BF. They would have my wife nurse for 20 minutes, then offer EBM fortified with formula, protein powder, and oil for the extra calories needed. That’s 2 different community hospitals and 1 major pediatric hospital, all on board.
            Needless to say, it was a very different experience from what we were expecting based on the outdated information in our birthing class. There may still be some “old schoolers” left, of that I have no doubt, but things are not the way they were when my mom gave birth to me, that is for sure.

          • How nice for you. With me it was multiple shifts of nurses doing this to us. There was not a blood sugar issue. I had a lot of really insensitive things said to me by the nurses, too.
            The mistake I see in NCB people and anti NCB people is trying to generalize hospital experiences without any statistics. I had a *horrible* time at the hospital and with midwives. I am literally traumatized by the behavior of midwives, an ob, nurses, etc involved in my baby’s birth. Being told that it ‘doesn’t happen’ is really dismissive of what I went through. I was there, and you weren’t. It isn’t some kind of freak accident that I was treated this way, its how those people choose to conduct themselves. Despite my efforts there have been no consequences for anyone involved, so I doubt anyone has changed the way they conduct themselves.

          • Tim

            I’m not saying it doesn’t happen, my apologies if it came across that way. What I was saying is that I was all prepared by my birth class for that to be “the norm” – the way it was decades ago, because of the outdated materials being used in class. And then when we got there, it wasn’t like that at all – at 3 different hospitals in my region. So I was saying, it’s not the “standard” experience anymore that people can reliably count on happening. There are holdouts , as you experienced as well – but the shift is underway is what I was trying to say.

          • AmyP

            Yeah, I’ve had babies at three different hospitals (two hospitals in DC, one in Texas) and I’ve never encountered a formula pusher. My middle child was a huge 10+ pound baby and they cup-fed him a single dose of formula at birth to control his blood sugar, but otherwise, I’v never seen formula in a hospital.

          • Amy Tuteur, MD

            There’s no evidence that giving formula in the hospital interferes with breastfeeding. Lactivists want to ban it because they know that when mothers see how easy it is to give formula, and how happily babies take it, they won’t be as likely to persevere through pain and other breastfeeding difficulties.

            It’s all part of the campaign to demonize formula and to pretend that women stop breeastfeeding for anything but the real reason: it’s difficult and painful for many.

          • Tim

            100% Agreed – they were just working out a schedule for us that would get the baby experience at the breast, and help stimulate production, while also allowing her to get the extra calories she needed.
            We would have had no problem with just supplementing with straight up formula if it would have helped (and ended up switching to just fortified formula eventually because of allergies and dwindling supply) – the reason they were doing the fortified instead of just extra bottles was because she was too weak/sleepy from her heart issues to drink enough liquid in the first place for the necessary calories. So she got some normal 20/cal milk right from the source, plus bottles with extra (22, then 24, then 28, then 32 cal eventually)
            Overall it was a huge contrast from the bradley course material, which insisted that everyone we met at the hospital would sneak formula without telling us, lie to make us give it to her, etc. They prep you for an environment that is going to do everything in it’s power to “force” you to give up breastfeeding, and seemed laughably caricatured when we saw the reality.

          • RainyNightHouse

            Did you consider at all that perhaps your experience was not a common one though? I’ve had three separate hospital experiences having babies. My first were twins, I got woeful support. Quit at six weeks due to pain from latching problems, and lack of support. I had a VBAC 3 years later, better support that time – due merely to the luck of the draw as to what staff were on. Some are useless, some amazing, some middling. Had my second VBAC and got decent support but didn’t seek much as I’d already had a successful bfing relationship before and knew what felt ‘right’.

          • ngozi

            Even though I like breastfeeding my children, I haven’t read or heard a lactivist address how a woman is supposed to cope with breastfeeding if she doesn’t have any support at home. Breastfeeding can be very hard in American culture because many women are dealing with partners who don’t appreciate being “pushed aside” for the baby and dealing with raising other children while raising a newborn.
            Everyone can’t depend on a helpful partner or granny to take care of everything while the woman breastfeeds. I can tell you from experience, when that happens, breastfeeding gets pretty tough. I haven’t really seen this issue addressed in the breastfeeding books and info.

          • RainyNightHouse

            I don’t really get what you’re saying, because your comment seems to imply that if a woman doesn’t breastfeed then the baby barely needs dealing with at all. “Everyone can’t depend on a helpful partner or granny to take care of everything while the woman breastfeeds.” – I assume you mean ‘Not everyone can depend on..’ etc etc. Right so, if a woman doesn’t breastfeed who’s ‘taking care of everything’ while she’s sterilising the bottles, boiling the water, measuring out the powder, making up the feed, and after all that THEN feeding the baby??? *Not* breastfeeding makes everything more difficult, time-consuming, expensive, – the list goes on and on. Whereas I can just put the baby on my boob, feed him, put him down to sleep, then get on with everything else. Once a woman has support getting over the difficulties, breastfeeding becomes a breeze, and it is BY FAR the easier option – believe me, I know. I’ve done both.

          • breastfeeding becomes a breeze, and it is BY FAR the easier option

            … for you. It was the easier option for you. This is not true for everyone.

          • Poogles

            “*Not* breastfeeding makes everything more difficult, time-consuming, expensive, – the list goes on and on. ”

            This is not always true, since not everyone can just “put the baby on my boob, feed him, put him down to sleep, then get on with everything else.” A woman who spends thousands on lactation consultants, pumps, antibiotics, galactogogues, etc. and still has to spend 45 minutes to an hour with the baby at the breast and then pumping afterwards (with added time for storing or feeding the pumped breastmilk, and cleaning the pump) would likely not consider breastfeeding to be easier, quicker or less expensive than exclusively formula feeding. For some women, the entirety of their breastfeeding relationship with their child will involve quite a lot of time, expense and effort. She may still decide to stick with it, for whatever reason, which is completely valid, but it doesn’t mean it is the easier/quicker/less expensive option.

          • ngozi

            I stuck with it as long as I could because my breastfed babies sleep better at night than my bottle fed ones. And I didn’t want to go through all the formula allergies with formula. Breastfeeding isn’t for everyone, though.

          • Sullivan ThePoop

            It doesn’t really. My twin nephews were formula fed and I have never found it the least bit difficult. You also do not have to sterilize bottles if you have a dishwasher and you don’t have to boil water in most areas.

          • Certified Hamster Midwife

            Heck, if you have a water cooler or fridge that dispenses hot water, you don’t even need to heat the water up yourself.

          • Mac Sherbert

            Or if you baby will take a cold bottle! I never gave mine a heated bottle and they never seemed complain about it being cold.

          • Mac Sherbert

            Your experience is not everyone’s experience. I’ve done both and I think formula was way easier.

            My 2nd never wanted to be parted with the breast. (Actually, still doesn’t when it’s time to rest at 11 months!). I understand exactly what she means by support at home. We don’t have any close family to come over and help out regularly and my husband had work crazy hours right after my 2nd baby was born. It was hard to balance breastfeeding my 24/7 boob attached newborn and caring for my 4 year old.
            As for fixing bottles…I have dishwasher and water does not always have to be sterilized depending on where you live (per my pediatrician). Bottles can be made in advance. As for cost, what’s my sanity worth? More than a can of formula!

            When you have baby that wants to feed for 45 minutes then eat again an hour later, it gets totally exhausting. It is easier when someone else can feed the baby. I can’t cook supper for my family with a baby sucking away on my breast, but I can cook while my husband gives the baby a bottle. (And no he can’t cook…I wouldn’t want him to even if he offered.)

            I also find easier to pack a bottle rather than trying to bf when out. I don’t have to worry about what my other kid is doing while I’m feeding, I don’t have to pack a cover, I don’t have to worry if there will be a place for me to bf, I don’t have to worry my clothes are bf friendly.

            In my reality, BF is way more time consuming and demanding than bottle feeding.

          • ngozi

            Hooray! Someone got it!!!

          • ngozi

            I don’t know how you came to the conclusion you state in your first paragraph.

          • RainyNightHouse

            “It’s all part of the campaign to demonize formula and to pretend that
            women stop breeastfeeding for anything but the real reason: it’s
            difficult and painful for many.” – No, lactivists KNOW the real reason women stop, and that is that ‘it’s difficult and painful for many’ and there IS NOT ENOUGH BREASTFEEDING SUPPORT. With the right lactation support women can overcome breastfeeding difficulties and then reap the rewards of a successful breastfeeding relationships which can be one of the most satisfying, bonding and nourishing (to *both* mother and baby) aspects of motherhood.

          • Poogles

            “With the right lactation support women can overcome breastfeeding difficulties ”

            Some will be able to overcome their difficulties with proper education/support, some will not be able to overcome their difficulties, and some will decide they don’t even want to bother trying to overcome their difficulties. Unfortunately, most lactivists ignore that some difficulties just cannot be overcome (no amount of support is going to effect IGT, for example). Most also ignore that it is completely valid for some mothers to not want to invest a ton of energy into making breastfeeding work because it’s just not that important to them, personally.

            Not every mother will find breastfeeding to be “one of the most satisfying, bonding and nourishing (to *both* mother and baby) aspects of motherhood” – that is purely subjective and experiences vary widely, even among mothers who don’t have complications. For some mothers it’s just feeding the baby. Conversly, some mothers who exclusively formula-feed will find bottle-feeding their baby to be “satisfying, bonding and nourishing”.

          • Lizz

            Really where? Because when I chose not to breastfeed the second time was when I caught hell.

          • ngozi

            Let’s say it together people: “Just Say NO.”

          • RainyNightHouse

            Me too Shameon – my twins were difficult to latch and sleepy just after birth, and all the nurses would just say, Oh well let’s just give them a bottle then. Here in Ireland the breastfeeding rates are woeful.

            Tim: “97 different total strangers will come and mash your newborns face into your breasts every opportunity they get nowadays.” – yeah the ‘mashing’ doesn’t really work..

    • Squillo

      No, they shouldn’t. But they have been. In the worst possible way. The question now is, what punishment does the midwife–who seems to have disregarded all common and professional sense–deserve?

    • ngozi

      But you can have an idyllic (but medically sound) experience in the hospital as well! If people would bother to do their homework and ask their OBGYN questions about their policies, rather than assuming they are the bad guy, then they would find that hospitals rarely force women to do anything. When I didn’t want an epidural, I did like Nancy Reagan and just said no.

    • theNormalDistribution

      I’m so confused. I thought the most important part of having a baby was, like, actually having a baby when you’re done having a baby.

  • Amy Tuteur, MD

    OT/Legal update:

    I’m happy to report that the judge agreed with our arguments and those of the EFF/DMLP and denied Gina’s motion to dismiss. The case will be going forward. Details to follow.

    • kumquatwriter

      WOOT.

    • An Actual Attorney

      Cannot wait to read, obviously. Please post as soon as you can.

  • Allie P

    So much emphasis on the music in this story! makes me wonder if these poor parents can ever listen to those songs again, knowing they were concentrating on soothing music while their baby was fighting for his life. I had a pretty “idyllic” birth in the hospital.
    I’m not sure what bothers these folks so about a hospital that they would go to such risks. If I wanted music on, that’s why God made ipods.

  • amazonmom

    Have to come here for some breathing room. Someone in my pregnancy group asked about Tdap in pregnancy. I told the group the CDC guideline is one every pregnancy, optimally between 27-36 weeks. Now someone is saying that this “CDC” isn’t paying attention to how many pregnancies or how close together they are. Well actually, the CDC (no quotes, the CDC is what it is) has a page about just that topic. I posted the link. OMG I’m so meen wanting to follow CDC recommended schedules!

    • GuestK

      It must have changed a lot since I had my last baby only 2.5 years ago. I really wanted the vaccine then but my doctor had me wait until after birth. I was disappointed but I made sure I got it before I left the hospital. With there having been pertussis outbreaks in my state I wanted us to be as protected as possible. Glad the recommendations have changed!

      • amazonmom

        http://www.cdc.gov/vaccines/vpd-vac/pertussis/tdap-pregnancy-hcp.htm

        Guidelines changed in 2012. Pertussis has been running rampant in WA state, I got my Tdap today at 27 weeks.

      • Young CC Prof

        Yup, it’s brand new. When the pertussis outbreaks spiked a year or so ago, they did some experiments and figured out that if pregnant women (even those with up-to-date boosters) are re-immunized near the beginning of the third trimester, you get a spike in their antibody levels shortly before delivery, which means the baby is born with high levels of maternal antibodies.

        Maternal antibodies just last a few weeks, and breast-feeding only extends it a little, but those few weeks cover the time when infections are most dangerous. Even one-month-olds are much better equipped to fight infections than newborns.

        Right now, I’m trying to figure out the best time to get my flu shot. With a January baby, it’s particularly important to get the antibody spike in late pregnancy, which means I should probably wait until mid-October, but I also want to be completely sure I’m protected before the virus shows up. (Pregnant + asthmatic + multiple antibiotic allergies = significant risk of complications or hospitalization.)

        Ah, the minor and unimportant dilemmas of people who use science. If I only had my priorities straight, I could be stressing about which herbal belly balm to use instead.

        • amazonmom

          Within a month I get Tdap, flu shots. TB and glucola tests too. Topped off with some Rhogam in my butt. Maybe I need to get over my love of science!

        • Jocelyn

          This is great to know, thanks! I’m 32 weeks right now, and my doctor hasn’t mentioned this. I’ll ask him about when I’m getting my shot at my appt next week.

        • antigone23

          I wish someone had told me this. I got a TDAP after my daughter’s birth less than 3 years ago and was led to believe I wouldn’t need another one. I have a 2 week old newborn and am terrified of pertussis.

        • PrecipMom

          Due in January too, and recommendation is flu shot ASAP. Flu is dangerous for pregnant moms and developing babies. I got mine last week.

      • Amy H

        Every time I asked my OB about it she said to find out what my future pediatrician recommended. I’m not that into interviewing peds and the Dr I picked off the Medicaid list didn’t answer the phone anyway so I got it in the hospital.

        I thought that was ridiculous. Either it’s recommended or not. And I have an unvaccinated niece and two friends with unvaxed children, my dad is a school bus driver, my mom is a substitute teacher, and the news kept talking about whooping cough outbreaks even in a neighboring county.

    • Pregnant Guest

      I’ve looked for more information about the Tdap, but am having trouble finding it. Is there a general consensus on how long it lasts? I’m trying to make sure my immediate family who will be in close contact w/my baby are all vaccinated, and some of them got it about 4-5 years ago. Should they be vaccinated again?

      • amazonmom

        As long as the adults got Tdap and not just the tetanus/ diphtheria jab I think it’s ok. One pertussis booster is enough.

      • amazonmom

        Only if the shot they got didn’t include the pertussis booster. They should call the doctor or clinic where they got their shot and ask if it was Tdap. If not they should get it.

        • Pregnant Guest

          They’ve definitely all had Tdap. I was just seeing some new speculation that it might not last as long as previously thought (I think I saw something about an average of 5 years?)

          I was really mad because I missed the recommendation about getting it during pregnancy; my daughter was born 6 days ago, and everyone I asked if I should get it postpartum just cited the new “in every pregnancy” guideline. But I had it 4 years ago, and since I was no longer pregnant by the time I was asking about it, I was trying to figure out if the guideline was only about antibody transfer, which we were too late for, or if it had to do with waning immunity as well, in which case I need to get my family to get updated. (I ended up just having them give me one. Not sure if I needed it, but can’t hurt, right?)

  • sk
    • Dr Kitty

      I think this is where you might want to consider the possibility G-d might be trying to tell you that he doesn’t want you to have a waterbirth in a small town in Georgia.

      Also, the comments…
      I don’t like to mock the sincerely held beliefs of others, but if you think that an infinitely powerful, omniscient, omnipresent Supreme Being HAS to do a miracle, I’m not sure I can help it.
      Sorry, I know that’s not kind.

      • FormerPhysicist

        G-d always answers*. Sometimes the answer is “no”.

        *Though I don’t even quite believe G-d always answers.

        • Dr Kitty

          I get that.

          The idea that a Supreme Being HAS to do something…that an all powerful deity has limited options…I’m not sure they thought it through.
          Like I said, I’m not proud, and it isn’t kind.

          There’s a reason our first dance was Nick Cave’s “Into My Arms”.
          “I don’t believe in an interventionist G-d
          But I know, darling that you do
          If I did I would kneel down and ask Him
          Not to intervene when it comes to you”

        • Lizz

          My Mom always really emphasized listening to your answer even if you don’t like it. Also that sometimes God sends others to help as your answer such as a doctor. God is God of order who does things through logical means as much as possible.

          • Zornorph

            “Lady, I sent three boats! What did you want!”

          • LibrarianSarah

            I like the one where a women goes into financial ruin expecting god to have her win the lottery and when she asked god why god said “for the love of me lady, buy a ticket!

        • Squillo

          Sister Mary Ignatius for the win!

      • Hannah

        I hate the belief that God “has” to do anything. He doesn’t HAVE to do anything, you just really really WANT it and have convinced yourself that he MUST do what YOU want. Ugh, it’s so obnoxious and arrogant.

        • amazonmom

          Whatever happened to “do not tempt the Lord thy God”? God doesn’t have to do what you want.

      • Meh, I feel very much the same way. No, it’s not kind, but at some point I have to facepalm and write people off as willing participants in their own irrationality.

      • auntbea

        All you have to do is trick Him into promising on the River Styx!

      • Something From Nothing

        Well, it might not be kind, but really? What else do you say to that? i retract… i think it just might be kind to gently point out to people how irrational their thinking is. Oh my, life seems so much more straight forward when you leave god out of the equation.

  • Mel

    *Shudders* How can people get so wound-up about the environment of the birth rather than the survival of the baby.

    • Niemand

      Partly, I suspect, because they’re so convinced that nothing can possibly go wrong. If everything is totally safe, why not concentrate on the aesthetics? Hence the propaganda about birth being “as safe as life gets” and so on.

    • Amy Tuteur, MD

      Because they were told that the baby was guaranteed to survive.

    • Bombshellrisa

      Because they can-I have a friend who lived a terrible childhood in a country where it was routine to see women die in childbirth and children to starve to death. She could have cared less about candles and music, but she did find out which hospital had the best NICU and how many deliveries they see a year. Her baby didn’t need the NICU, but that was HER concern about environment (which is quite sensible concern wise). She figured giving birth in a hospital with doctors and medicine right there was all she had to worry about for herself.

  • Squillo

    The midwife said: “It was not her fault that this [charting of the monitoring she seems to claim she did] did not occur, as she did not have anybody else working with her.”

    If it’s too tough to chart when you’re working solo, what happens when the mother and neonate both need skilled help at the same time?

    To me, that seems like unforgivable negligence.

    • auntbea

      It’s not my fault I crashed, officer! I was drunk, so I couldn’t see straight! There was no way that could have been prevented!

  • Antigonos CNM

    If the head was almost crowning at 10:30, that baby should have been born within an hour, if not minutes. If by midnight, there was no progress, the mother should have been transferred, certainly not as late as 1:30 should they be discussing whether to transfer or not. I don’t think the baby was alive when the transfer began, frankly.

  • Amy Tuteur, MD

    OT: Amy Tuteur Awesome takedown of Melissa Cheyney on Slate:

    “The main battlefield today is over home births. About 1 percent of women in the United States choose to give birth at home. Counterintuitive as it may sound at first, they often cite safety concerns—they’re worried about unnecessary procedures if they give birth in a hospital. And they “trust their bodies’ inherent ability to give birth without interference.” Melissa Cheyney is an anthropologist at Oregon State University as well as a home-birth advocate and midwife. She reports that women who choose home birth “value alternative and more embodied or intuitive ways of knowing.” Home-birth advocates say women are better off giving birth in a comfortable environment, letting nature take its course.

    I’m personally opposed to letting nature take its course—nature will kill you. And “intuitive ways of knowing” is just a flowery term for “ignorance.””

    http://www.slate.com/articles/health_and_science/science_of_longevity/2013/09/death_in_childbirth_doctors_increased_maternal_mortality_in_the_20th_century.html?wpisrc=flyouts

    • THIS ARTICLE CONTAINS DOWTON ABBEY SPOILERS WITHOUT A WARNING!

      • BeatlesFan

        Thank you for the warning!

      • Antigonos CNM

        Even in Israel we’ve had season 3!

        • BeatlesFan

          Oh, I thought she meant season 4, I didn’t want to check and end up reading the spoilers!

  • Dr Kitty

    Update: the inquest has concluded- death by misadventure.

    The coroner has concluded Midwives should not attend HBs alone, the emergency services should be notified and given prior warning when a HB occurs, and “that the distance of a home birth from the local maternity hospital should be factored in whenever home deliveries are planned.”

    No Shit Sherlock!

    This is why homebirth simply hasn’t taken off in ireland- the infrastructure and logistics make it unsafe for anyone outside of Dublin, Cork, Limerick or Galway.

    • Renee

      Misadventure? Perfect word, really

    • Karen in SC

      do you think this will be a cautionary tale to the woman who sued for the right to homebirth against medical advice?

      • Helena Handbasket

        That’s a rhetorical question, right?

        Last I heard, she’s heading to England, claiming to be a “birth refugee”. GMAFB.

    • Mel

      I live in Michigan, USA. We live a minimum of 30 minutes from a hospital – more if it’s icy or snowing or whatever fresh hell the weather throws at us. We’re never having a baby at home.

  • Lynn

    Sigh – An IPod, little flamless (battery) tea lights, and essential oils – all of those are fine to use in a hospital and can help create ambiance, while having life-saving equipment right there. As long as everything is going well, a good RN/OB/CNM will keep the lights dim, minimize disturbances, etc. And if it isn’t, all those monitors and having an OR right there probably matter more than ambiance.

  • Amy M

    Have we heard of any stories where a woman has an uneventful hospital birth, that she is really happy with and everyone is fine, but then she decides “hey, you know what I really missed out on? A better experience with candles and soft lighting. Next time? Home birth for sure!”

    As far as I can tell the homebirthers fall into three groups:

    1)The ones who have never had babies before and have no idea what they are in for, and get snared by the NCB brain trust. A sub-group may be those who don’t trust/fear modern medicine.

    2)The ones who had a horrific/scary experience in the hospital and are afraid to go back, so much so they are willing to risk their babies’ lives. I think a sub-group of these are those who can’t afford hospital birth.

    3)The ones who have already had a homebirth, regardless of whether they come from group one or group 2 originally.

    • I was terrified by what I saw working in hospitals. I was worried about forced interventions because of a history of sexual abuse. I didn’t want my mental health to be compromised while caring for my baby. I felt that the relative risk was low generally. I’m not in any of these groups.

      • Amy M

        Oh of course, there will be some who fall outside, I am generalizing to make the point that it usually doesn’t go the other way—as in someone who was happy with a hospital birth decides to have a home birth. Someone familiar with birth, whether or not the experience was good, probably won’t romanticize it the same way that someone who never has had a baby might.

    • multimom

      I’ve given birth five times. Yet to have music and candles. Did have Super Troopers playing in the background last time.

      Five births, five healthy babies. Pretty idyllic in my mind.

      • Amy M

        Oh, I’m with you…healthy babies are what make the birth as far as I am concerned. The birth of my children was actually pretty relaxed, thanks to an epidural. 🙂

        • multimom

          Lol! Seriously, I bit into some of the woo and went all natural with my first three. Including my first with magnesium sulfate and pitocin. My fourth stalled out and it was my birthday so I decided “screw this” and got an epidural. He was out in an hour. With baby 5, no question got the epidural immediately. I have the best memories of sitting there with the hubs, no longer freaking out about having a fifth child, and just having a truly peaceful birth. Because I knew, if anything went wrong, I was in the right place.

          • moto_librarian

            My first birth was unmedicated. The experience was so awful that I wasn’t sure I ever wanted to have another baby. With our second, I got the epidural as soon as I was admitted at 5 cm., and it was bliss. The only snag was when my catheter dislodged during transition (I was freaking out that I was going to have to push without pain relief), but the anesthesiologist got there and redosed me even though I was complete. I had absolutely no pain during delivery, not even during crowning. It was peaceful and happy.

      • AmyP

        We watched Portlandia last time.

        • Allie P

          Arrested Development for me.

      • Squillo

        Le nozze di Figaro for me.

        Gave new meaning to “Non so più cosa son, cosa faccio…”

      • Mishimoo

        Quiet for the first two, accidental play list for the third – husband was mucking about with the laptop and accidentally turned on some of my favourite music at just the right time. (Rev Theory and Ill Nino).

    • auntbea

      I had a friend who had a perfectly fine birth at a hospital, but wanted it to be transcendent. Or something.

      • Amy M

        So she went home for the next one?

        • auntbea

          Yep. And posted a picture of the baby born in the water in the caul. Both children now attend a neighbor’s home-based Waldorf program.

          • Amy M

            Wow. I guess it was transcendent then. I still think your friend is the exception though.

      • kumquatwriter

        I labor to Religulous and Fiddler on the Roof

        • kumquatwriter

          ER, that was supposed to go below, disqus. Wtf?

          • auntbea

            That’s okay. I labor to whythehellistheremusicplayingturnitoffturnitoff!

    • oh hey I forgot to add that ricki lake’s first hospital birth was fine. In the ‘even more business of being born’ she talks about it because she gave the impression that it was a negative experience and it wasn’t. it just wasn’t as cool as her homebirth I guess?

      • Allie P

        She was snookered into believing that she shouldn’t have had an elective section, I thought?

        • the other lady on BOBB had a section for pre-term labor and IUGR (i think?). Ricki lake had a hospital birth with drugs and CNMs the first time around.

          • Anj Fabian

            Placental abruption IIRC.

    • Lena

      I’ve heard of plenty of women with happy, uneventful hospital births, and then started reading NCB nonsense and convinced themselves they were traumatized by their experiences.

      • Amy M

        True…and sad.

      • Karen in SC

        Wonder if there is a name for that phenomenon. Delusional Munchausen’s?

        • Sullivan ThePoop

          All the homebirth stories I read are rife with psychological issues. I think what they really teach CPMs is how to play psychological games with your clients instead of any kind of medical knowledge.

      • Guest

        ^this. I’ve also heard HBers state that a lot of women aren’t traumatised by their hospital births because they just don’t *realise* how traumatic they were. So, people who were previously happy with their hospital experience are convinced that there was actually something horrible and dehumanising about the experience, and that all of the interventions they had were “unnecessary” and violating. I loathe these jerks.

        • Mishimoo

          Exactly! I actually surprised someone by referring to my latest delivery as “A really positive experience”. To me, it was. Yes, it was hard. It was harder that the other two but we have a healthy baby. I also got to have one of my favourite CNMs there, we gave a student CNM a really good learning experience, it showed my little sister why a hospital birth is a good idea, and I felt safe and loved.

          *I* asked for the interventions, because I felt like I wasn’t getting anywhere and we wanted a healthy baby. They were not forced on me, they were requested and chosen after monitoring and communication with medical professionals. I was also offered adequate pain relief several times. I’m really happy with how things turned out, and really don’t understand why I shouldn’t be.

          • Amy M

            Oh there were certainly aspects of my children’s birth that was less than fabulous, like the pph and the hospital food. But the staff was wonderfully kind and considerate the entire time I was there (incl the hospital bedrest long before the babies were even born, and hospital bed rest in and of itself sucks), knowledgeable and efficient. They got my babies safely born, with minimal pain and we all went home more or less in one piece 3 days later, with , as far as I can tell, all of our brain cells intact. No one was traumatized or left permanently damaged, therefore, it was a really positive experience in my book as well.

      • Sullivan ThePoop

        Kind of like someone I know who has an autistic child that started reading antivax nonsense and convinced herself that her daughter was vaccine injured.

    • SF Mom & Psychologist

      I know 5 women who have had homebirths.

      – Three fall into one of your categories.

      – The fourth had a totally natural, problem-free hospital birth but chose homebirth for her second because she “was looking for something different this time.” That struck me as odd. She ended up having a postpartum hemorrhage at home, was unconscious by the time she got to the ER (5 minutes away) and survived thanks to luck and amazing medical care. Her husband had PTSD.

      – The fifth also had a totally natural, problem-free hospital birth but came up with some totally irrational reasons for having a homebirth the second time around (including living too far from the hospital – YIKES!). All went fine but her midwife didn’t arrive in time to catch the baby, and it was an unintended UC.

      • Allie P

        I would have PTSD if I saw my partner passing out from blood loss in my house, too.

    • Guest

      No, I know two couples that are having HBs after positive hospital experiences, their reasoning? The hospital birth was “good, but not great” and the other couple feel that a good outcome at hospital the first time around guarantees that the mother and baby will be fine second time around, so they now have an attitude of “why bother” going to the hospital. Both couples appear to subscribe to the belief that nothing can go wrong at home that they can’t make it to hospital in time to fix, with one couple being particularly convinced about the existence of “the cascade of interventions” and the notion that bad things mostly happen as a product of OB interference.

      I’m sitting here hoping to god that there are no SD’s, cord prolapses, placental abruptions or other things that require prompt expert care, and for which a 40-minute trip to the nearest hospital won’t be even nearly adequate (not sure of the length of trip for both couples, but that is the distance for one of them in light traffic). I hate it when people I know and care about choose to HB… leaves me spending the entire pregnancy nauseated with worry.

      • Lena

        It’s f’ing BIRTH! No matter how it happens, there’s going to be a significant amount of pain involved. How “great” do they expect things to be?

        • Young CC Prof

          Yeah, I don’t get this “you’re suppose to enjoy it.” I can see the benefit to thinking of it as a difficult thing that you’re going to have to DO to achieve your goal of parenthood, rather than thinking of it as something awful that’s going to happen to you, like a car crash. (This kind of attitude would probably be especially useful if you’re living in a time or place where pain relief is simply not available)

          However, it’s pretty silly to expect it to be fun like a day at the beach.

    • Amy M

      Ok, so we HAVE heard a few stories where some women really do decide to go to home birth, after having a lovely hospital birth. It does seem to be fairly rare, but clearly it happens. That blows my mind.

  • they told her it would be fine, over and over again, I’m sure. Thats the only real service homebirth midwives give- false hope. its comforting when you are worried. its too bad its not true.

  • Amy M

    You missed the mother saying (or hearing) she was told “it wasn’t your fault, sometimes babies just die, in hospitals too” which was in the original article.

    • Amazed

      I noticed that, yet she claims that a doctor told her that had they come half an hour earlier, her baby probably would have lived.

      Personally, I don’t think I’ll have the guts to say to grieving parents that things probably would have been different and yes, it was their fault. I don’t envy the OBs who fell in that shift…

      • Amy M

        Oh, me either. Though really the OBs should be telling that to the MIDWIFE, since it’s really HER fault as the patient cannot be expected to provide her own medical care during her labor.

        • KarenJJ

          Yet the take home message for the midwife will be that OBs are hostile to homebirths for their own egotistical reasons and worried about her taking away their business…

    • Allie P

      That’s part of the problem. You’ve got a hospital staff reeling from a death, trained to comfort the grieving parents, trying to say SOMETHING and “you killed your baby by not being here” is not exactly bedside manner, so they don’t say that, they say “there’s nothing we could have done” (at this point), and the people go away thinking “there was nothing they could have done, either, homebirth wasn’t the culprit.”

  • Karen in SC

    Was the mother a primipara? Doesn’t that fact alone risk out of homebirth in the UK?

    • The Computer Ate My Nym

      If I understand correctly, this happened in Ireland, not Northern Ireland and therefore not in the UK. They’re quite definite about that, I’m told.

      • Dr Kitty

        TCAMN- that’s one way to say it. We are indeed QUITE clear the Ireland is NOT the UK 🙂

        This was a private, single handed MW, paid for in full by the parents. Not involved in the Irish state-run health service at all, hence playing very much by her own rules.

        • Karen in SC

          Oops sorry for the mistake!

      • Antigonos CNM

        It is my understanding that primips are now NOT excluded from homebirths in the UK. This was not the case when I was there: no primips, no multigravida with more than 4 children.

        • Christina Maxwell

          You are right. Even though there are well publicized figures showing the increased risk for primips. The midwives here seem to operate on the ‘it won’t happen to me’ principle.

    • Christina Maxwell

      Not in Scotland Karen, homebirth is increasingly being encouraged for almost anybody who wants it. And if you don’t want it at home you can go to an NHS birthing centre, some of which are 40 miles from the hospital and do not have access to doctors.

    • RainyNightHouse

      It was in Ireland, not the UK.

  • Amazed

    40 kilometers? 40 freaking kilometers away from the hospital? I can’t believe it. These parents just changed my perception of homebirthing fools. They didn’t even delude themselves into thinking that they were just 5 minutes away from their emergency C-section.

    The midwife would be a freaking criminal for accepting the mother as a client with this appaling distance alone. My grandmother lives 55 kilometers away from my parents and it’s usually about a 40 minutes drive – on a main road where cars drive much faster than in any village, town or city.

    • Dr Kitty

      40km in MAYO- that would be rural Irish roads, barely as wide as a US driveway, over mountainous terrain.

      You can Google map Kilsallagh, Westport to Castlebar- it’s 35km and Google thinks it will take you 35minutes.
      At 2am, on dark, winding roads, driving over a bog…it will take considerably more.

      I know Westport- that plan was sheer madness.

      • Amazed

        Oh my, it’s getting worse. Transporting a labouring woman over MOUNTAINOUS terrain? What on earth is natural about this? It must have hurt like hell. And that’s without considering everything else.

        • Dr Kitty

          Street view the route from Kilsallagh to Westport on the R335 on Google. Imagine it at 2am without street lighting.

          • thepragmatist

            That would have risked her out here, although there are “birth attendants” who will still attend births way out in rural areas. Dangerous. One was posted here, on an island, where the father was an EMT and revived the baby… so dangerous and sad.

  • I don’t have a creative name

    I was about to say #7 is not classic at all, but very unusual, but then I got to #9 and saw that it was the same ole same ole. I have yet to see any midwife who is destroyed by the unnecessary death of a child – they all have crap to say about how sad it is that they didn’t make it earthside, blah blah blah, but I have yet to see even one of these stories where she takes full responsiblity for her actions or lack thereof.

    • KarenJJ

      I was surprised by that too. I wonder what happened between her time at the hospital when she said she’d never do another homebirth and her time later when she denied it. Was being around other professionals intensifying her feeling of failure at the time, did she find online cheerleaders who talked her around to it being ‘some babies just die’, or was there some other sort of rationalisation going on?

      • thepragmatist

        Oh, could it have been the threat of a lawsuit?

      • its cognitive dissidence. when your deeply held beliefs butt up against reality a very uncomfortable set of thoughts begin to emerge, they usually aren’t neat or cohesive. she will figure out what she really thinks over the long term I’m sure. Hopefully she will become a voice of rationality about how inadequate her training was for the crisis that occurred.

        Are there any ex-midwives that have spoken out against DEM?

  • The Computer Ate My Nym

    She only wanted to go to hospital if it meant the baby’s birth was at risk.

    That would be as soon as labor starts. Every labor and delivery carries the risk of the baby dying, especially if the mother is attended by an incompetent practitioner without adequate backup in case something goes wrong. It carries the risk of the mother dying too. Bring some candles and a sound track to the hospital if you feel the need, but get competent help!